This may happen. Most women using Sayana Press will experience a change in their bleeding patterns. According to a clinical study, some women experience irregular bleeding with 60% of women experiencing little or no bleeding after 12 months of use.

Every woman reacts to Sayana Press differently. Studies have shown that after one year’s use, 38% of women put on more than 2.3kgs of weight, 50% remained within 2.2kgs of their initial body weight and 12% lost more than 2.2kgs from their initial body weight.

For Sayana Press to be most effective it MUST be given every 12-13 weeks and no later than 14 weeks past your last injection.

If you are on holiday or not able to get your next injection before it is due, you should use alternative contraception once the 13 weeks are up and until you can get another injection. You will need to speak to your doctor or nurse before going back on Sayana Press as they will need to make sure that you are not pregnant before giving you a new prescription.

Injection site reactions (including pain, tenderness, lump, persistent skin indentation/dimpling) may occur. You may feel some soreness or see redness around the injection site immediately after an injection. Mild reactions like this are common. If you get a reaction that worries you in any way, is particularly painful, or does not get better after a short time please talk to your doctor.

There is no overall increased risk of ovarian, liver or cervical cancer, according to a long-term study of women using Sayana Press. It actually showed that Sayana Press creates a positive, protective effect that helps reduce the risk of endometrial cancer in the womb.

What about breast cancer? Breast cancer is rare among women under 40 years of age whether or not you use hormonal contraceptives like Sayana Press. In fact, only 1 in 10,000 women under 20 will be diagnosed with breast cancer, rising to 44 in 10,000 by age 30. You should know that taking Sayana Press can slightly increase your risk of breast cancer, but the additional risk is extremely small — less than 1 in 10,000 women if you’re under 20 and 2-3 in 10,000 if you’re under 30.

Sayana® Press can cause bones to become thinner (by reducing levels of minerals in the bones). These effects are greatest in the first 2-3 years of use. This effect isn’t permanent. Bone mineral density tends to stabilise after this period and there appears to be some recovery when the medicine is stopped. 

It is not yet possible to say whether Sayana® Press increases the risk of osteoporosis (weak bones) and fractures in later life.

If you are concerned about having any potential risk factors for osteoporosis, please discuss with your healthcare professional.

You should discuss with your doctor before starting treatment if you have any of the following as an alternative contraceptive may be more suitable to your needs:

• Chronic alcohol and/or tobacco use
• Chronic use of drugs that can reduce bone mass, e.g. epilepsy medication or steroids
• Low body mass index or eating disorder, e.g. anorexia nervosa or bulimia
• Previous low trauma fracture that was not caused by a fall
• Strong family history of osteoporosis

If you use Sayana® Press, it may help your bone health if you take regular weightbearing exercise and have a healthy diet, making sure you get enough calcium from dairy products and vitamin D from oily fish.

Normally, the bones of teenagers are rapidly growing and increasing in strength. The stronger the bones are when adulthood is reached, the greater the protection against osteoporosis in later life. Since Sayana Press may cause teenage bones to become thinner at a time when they should be growing, its effect may be particularly important in this age group. Bones start to recover when Sayana Press is stopped, but it is not yet known whether the bone mineral density reaches the same levels as it would have if Sayana Press had never been used.

Teenagers should discuss whether another form of contraception might be more suitable with the person who provides your contraception before starting Sayana Press.

You can stop using Sayana Press at any time. If you decide it is no longer for you, remember to use an alternative contraceptive once the 13 weeks are up, unless you want to become pregnant.

Sayana Press can stay on shelves for up to 3 years after the date of production, when unopened. Check the Sayana Press pack to confirm the expiry date. Once opened the product should be used immediately or discarded.

Sayana Press should be stored at room temperature. It must not be stored in the fridge or freezer.

A clot can occur in a leg vein, signs of which include pain swelling and redness. However, if it moves up the veins into the lungs it can cause chest pain, breathlessness, collapse or even death. Signs of a blood clot in your eye may result in sudden changes in your eyesight (sudden loss or blurred vision). Blood clots can also form in the blood vessels of the brain causing a stroke. Symptoms of a stroke include sudden severe headache, slurred speech, weakness or numbness in the limbs especially on one side. If you do get any of these symptoms, see your doctor immediately and you should not receive any further injections.

SAYANA PRESS does not protect against sexually transmitted infections, including HIV infection, e.g. AIDS.

Safer sex practices, including correct and consistent use of condoms, reduce the transmission of sexually transmitted infections through sexual contact, including HIV. You should seek advice from your healthcare professional on how to decrease your risk of catching sexually transmitted infections including HIV.